{% load staticfiles %}
{% include 'check_logstate.html' %}
<link rel="stylesheet" type="text/css" href="{% static 'css/patient.css' %}" />
<div id="patient_EditDiv">
	<form id="patientModifyForm" enctype="multipart/form-data"  method="post">
        {% csrf_token %}
		<div>
			<span class="label">病人id:</span>
			<span class="inputControl">
				<input class="textbox" type="text" id="patient_patientId_modify" name="patient.patientId" value="{{ patientId }}" style="width:200px" />
			</span>
		</div>

		<div>
			<span class="label">病人姓名:</span>
			<span class="inputControl">
				<input class="textbox" type="text" id="patient_patientName_modify" name="patient.patientName" style="width:200px" />

			</span>

		</div>
		<div>
			<span class="label">病人性别:</span>
			<span class="inputControl">
				<input class="textbox" type="text" id="patient_sex_modify" name="patient.sex" style="width:200px" />

			</span>

		</div>
		<div>
			<span class="label">身份证号:</span>
			<span class="inputControl">
				<input class="textbox" type="text" id="patient_cardNumber_modify" name="patient.cardNumber" style="width:200px" />

			</span>

		</div>
		<div>
			<span class="label">联系电话:</span>
			<span class="inputControl">
				<input class="textbox" type="text" id="patient_telephone_modify" name="patient.telephone" style="width:200px" />

			</span>

		</div>
		<div>
			<span class="label">病人病例:</span>
			<span class="inputControl">
				<textarea id="patient_illnessCase_modify" name="patient.illnessCase" type="text/plain"   style="width:750px;height:500px;"></textarea>

			</span>

		</div>
		<div>
			<span class="label">医生:</span>
			<span class="inputControl">
				<input class="textbox"  id="patient_doctorObj_doctorNumber_modify" name="patient.doctorObj.doctorNumber" style="width: auto"/>
			</span>
		</div>
		<div>
			<span class="label">登记时间:</span>
			<span class="inputControl">
				<input class="textbox" type="text" id="patient_addTime_modify" name="patient.addTime" />

			</span>

		</div>
		<div class="operation">
			<a id="patientModifyButton" class="easyui-linkbutton">更新</a> 
		</div>
	</form>
</div>
<script src="{% static 'js/Patient/patient_modify.js' %}"></script>
